NJ drug deaths continue to soar as national numbers decline

Drug deaths in the U.S. have fallen for the first time during the opioid epidemic, according to provisional figures from the Centers for Disease Control and Prevention.
Wochit/ Ken Serrano

Sinaloa cartel in NJ: DEA agents from NJ and NYPD’s Queens Narcotics Major Case Squad uncovered 270 pounds of narcotics, including 140 pounds of pure fentanyl in an apartment in Kew Gardens, Queens on Aug. 1. The seizure was linked to the Sinaloa cartel.(Photo11: Office of the Special Narcotics Prosecutor for the City of New York)

For the first time since the federal government declared the opioid crisis an epidemic in 2011, the number of U.S. overdose deaths is edging downward — despite unrelenting carnage in states such as New Jersey, according to new preliminary data.

Fatal overdoses nationwide — fueled by prescription drugs, heroin and other opioids — topped 70,000 for the 12-month period ending in September 2017, before showing slight declines in the 12-month periods ending in October 2017 and then November 2017. That's according to provisional figures from the Centers for Disease Control and Prevention.

The new U.S. data — which are likely to rise as pending investigations classify more deaths as drug-related — come as New Jersey continues to battle a stubborn addiction problem.

New Jersey experienced a 36 percent jump in drug overdose deaths from November 2016 to November 2017, increasing from 1,886 to 2,556 deaths, the highest percentage increase in the nation, according to the CDC. Other data, previously reported, show drug deaths in New Jersey could top 3,000 in 2018.

"It was the perfect storm," Ocean County Prosecutor Joseph Coronato said about New Jersey's addiction mess. "First you had prescription painkillers pouring into the state then you had cheap and highly pure heroin. We were feeding the epidemic."

The synthetic opioid fentanyl has only worsened it, he said.

Heroin and fentanyl are so plentiful in New Jersey that Camden drug dealers now have free heroin days to spur more addictions and draw more customers, he said.

Nonetheless, the new CDC data represent a glimmer of hope in what has been the worse public health crisis in a generation: annual drug deaths across the nation still exceed the total for all the U.S. lives lost during the Vietnam war, about 56,000.

“It’s too soon to make a national call,” said Jim Hall, an epidemiologist at Nova Southeastern University in Fort Lauderdale, Florida, who has studied the epidemic. “However, in certain states we’re seeing a leveling off.”

Hall said there are two key factors for the reported declines around the country: wider distribution of the overdose antidote naloxone and success in steering revived overdose victims into treatment from emergency room beds.

“Places that are doing these things are seeing some positive results,” Hall said.

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Overall, nationwide drug deaths have risen from 47,523 in the 12-month period ending in January 2015 to 70,070 for the 12-month period ending this past September, according to the CDC. But the one-year drug death total ending in October shows a leveling off at 70,057. That slight decline continued into November, when 69,948 people died of drug overdoses in that 12-month time frame, according to the most recent provisional figures.

'Easily. Too easy'

The experience of former New Jersey resident Jake White, a recovering drug user who now lives in California, helps explain why the preliminary data show the death toll retreating nationally.

Jake White, 21, of Toms River now in California, survived a fentanyl overdose but a half dozen people he knew didn't.(Photo11: Courtesy of Fran Scorzo)

A half-dozen people White knew in Ocean County, through family and friends or people he used with, have died of overdoses after fentanyl started turning up in heroin bags.

White, 21, originally from Toms River, overdosed and was revived with naloxone, the opioid overdose antidote, six times since 2015. He said his last overdose was his closest brush with death.

His mother happened to check on him in the middle of the night in her Seaside Park home in March 2017. He said he had turned blue. White woke up after medics or police used naloxone on him. When he went to the hospital, with family around him, it was clear he barely made it.

“I was crying, they were crying, we were all pretty upset,” he said.

Jake White, 21, of Toms River, now in California. He survived a fentanyl overdose but a half dozen people he knew didn't.(Photo11: Courtesy of Fran Scorzo)

White was placed in a California rehabilitation center through the Blue Hart (Heroin Addiction Recovery Treatment) program in Ocean County, which steers people with addictions into treatment, sometimes after they’ve walked into participating police departments.

Now, White is 10 months sober and working as a cook in California. Still, there are frequent reminders of the risks of relapse. A 25-year-old man White befriended at a rehabilitation clinic died of an overdose around Christmas, he said.

“It could easily have been me,” he said. “Easily. Too easy.”

Last year, Ocean County saw about a 21 percent year-over-year decline in overdose deaths after putting in place its Blue Hart program and expanding the use of naloxone. For a video on the heroin and fentanyl trade in New Jersey, scroll up.

Reports of declines

The experience across the nation has not been uniform.

Overdose death figures maintained by the New Jersey Attorney General's Office still list 2017 figures as pending. But the state offers estimates for 2018. Through June 11 of this year, there have been 1,324 overdose deaths in New Jersey, a tally on track to hit 2,938 for this year.

But even that figure shows a slower rate of increase from the rise between the 12-month periods ending in November 2016 and 2017.

Bags of pure fentanyl(Photo11: Courtesy of the DEA)

Elsewhere, drug deaths have fallen, including in Florida, Hall said. "It's still too early to tell but at least Florida may be transitioning from its escalation phase to a plateau phase preceding a period of decline,” he said.

Naloxone and revived overdose victims being steered into treatment are behind the decline there as they are nationally, he said.

Florida is significant because it has been particularly hard hit. Drug deaths there doubled from the 12-month period ending in January 2015 and September 2017, rising to 5,586, according to the CDC. But like the country on the whole, they dropped in both periods ending in October and November, the latter showing 5,401 deaths.

Massachusetts experienced a lower number of drug overdose deaths in 2017 than in 2016, said David Rosenbloom, a professor at Boston University’s School of Public Health who studies the epidemic.

Rhode Island also saw a slight decrease in the number of deaths from 2016 to 2017.

Both Rhode Island and Massachusetts have taken an aggressive approach to ushering people with opioid addictions into treatment.

New York City saw a 12 percent decline in overdose deaths in the fourth quarter of 2017.

According to the CDC's 12-month preliminary figures ending in November 2017, seven states saw year-over-year declines in overdose deaths: Idaho, Kansas, Montana, North Dakota, Rhode Island, Utah and Wyoming.

A trap house showing fentanyl and tools of the drug trade(Photo11: Courtesy of the DEA)

Elsewhere locally, Monmouth County saw an 11 percent decrease from 2016-2017 in opioid-related fatal overdose deaths, Monmouth County Prosecutor Christopher Gramiccioni said. There was a 26 percent decrease comparing the first quarter of 2017 with the first quarter of 2018, he said.

There are other efforts in play that may have helped bring down the death toll.

Last July, the CDC reported the first decline in the United States in opioid prescriptions since the opioid crisis began in the late 1990s.

Legislative efforts like the one in New Jersey in 2017 limiting the initial prescriptions for opioids to five days for acute pain have helped reduce prescriptions.

An 1840 hypothesis

In 2013, researchers at Columbia University took a page from the playbook of 19th Century British surgeon and statistician William Farr, applying what’s known as Farr’s Law of epidemics to the opioid crisis.

Farr's Law was used to predict the rise and fall of the cattle plague of 1885 as well as the AIDS epidemic with varying success.

With Farr's model and calculations of rates of increase, the Columbia researchers predicted that the opioid epidemic in the U.S. would peak in 2017.

"Their prediction of a stabilization in 2017 appears to be what’s happening, at least in places that are addressing the epidemic," Hall said.

Wave of death

Despite what may be an accurate prediction from the Columbia researchers on the epidemic's peak, their forecast of the number of annual overdose deaths fell short after 2014 because of one deadly unanticipated factor: fentanyl.

“At that time there wasn’t any information, any clue with regard to fentanyl,” Guojua Li, a professor of epidemiology at Columbia University and co-author of the report published in December 2014 in Injury Epidemiology. “That was totally off our radar (in 2013).”

Aside from an wave of fentanyl deaths in the mid-2000s, the Drug Enforcement Administration first mentioned fentanyl in its National Drug Threat Assessment Summary in November 2014. It reported then that fentanyl-laced heroin started turning up in 2013.

The fentanyl used to spike heroin — unlike diverted pharmaceutical fentanyl — is made in labs in China and Mexico, the DEA reported in last year’s Drug Threat Assessment Summary.

Fentanyl is synthesized in laboratories from chemicals alone. Drugs like heroin are natural opioids — they require plant-based alkaloids. Fentanyl is up to 50 times more potent than heroin, according to the DEA.

As little as two miligrams, a few grains, can kill a user.

Two milligrams of fentanyl, a fatal overdose(Photo11: Courtesy of the DEA)

For the 12-month period that ended in January 2015, 5,766 people suffered a fatal overdose involving a synthetic opioid, mostly fentanyl and its analogues like carfentanil, according to the CDC. The 12-month provisional figure for November is 27,902.

That’s nearly a five-fold increase.

Even if the Columbia researchers are correct about the epidemic's peak, legions of people will continue to die before the drug deaths drop to the levels of the late 1990s when the death toll started to climb. It won’t get there until about 2030, according to the Columbia study.

Drug deaths will reach their 1980 level of about 6,000 deaths by 2034, the study predicts.